ONCOLOGY Vol 34 Issue 7 | Oncology

Immunotherapy in Advanced Lung Cancer

July 15, 2020

Review Article

ABSTRACT Historically, platinum-based chemotherapy was the standard of care for metastatic lung cancer. However, since the success of immune checkpoint inhibitors (ICIs) in melanoma, PD-1/PD-L1 and CTLA-4 immune checkpoint pathways have been established as effective therapies to manage advanced non–small cell lung cancer (NSCLC) and extensive-stage (ES) small cell lung cancer (SCLC). Multiple large-scale randomized clinical trials have analyzed the effects of ICIs in NSCLC, and results of these trials have since translated to the approval of single-agent PD-1/PD-L1 inhibitors, and the combination of PD-1 inhibitors with platinum-based chemotherapy has become the new standard of care for patients with advanced NSCLC. Furthermore, in ES SCLC, in which chemotherapy or chemoradiation has been the standard of care for decades, 2 anti–PD-1/PD-L1 agents have been approved for use in the frontline setting for ES SCLC, in combination with chemotherapy. Despite progressive integration of immunotherapy into treatment regimens, there remains a need for reliable biomarkers to precisely determine therapy candidates.

Ineptitude of Clinical Trials System Highlighted by COVID-19 Pandemic

July 15, 2020

Perspective

The coronavirus disease 2019 (COVID-19) pandemic has permanently changed many aspects of clinical care, including clinical trials. A short list of the challenges faced by the entire research community during this pandemic include (but aren’t limited to) enrollment and protocol adherence difficulties, needing to reduce patient visits, staffing constraints, and limited availability of ancillary services.

Emotional Distress During the COVID-19 Pandemic: Psycho-Oncology Perspective

July 15, 2020

Clinical Quandaries

ABSTRACT Patients with cancer represent a vulnerable population and are at greater risk of developing serious complications as a result of a COVID-19 infection. In response, oncology societies around the world have proposed changes to their standards of care. These changes have helped guide health care providers in prioritizing clinical management of patients with cancer: identifying situations in which urgent intervention is needed and those that can be triaged until the risk of infection has lessened.

Oncology Clinical Trials During the COVID-19 Pandemic

July 15, 2020

Review Article

ABSTRACT The coronavirus disease 2019 (COVID-19) pandemic has rapidly spread all over the world in the past several months. No effective treatment for COVID-19 has been established. High transmissibility and considerable mortality rates have forced many national governments to implement quarantine measures. Many patients with cancer rely on clinical trials to receive their oncologic care, but the routine conduct of clinical trials has substantially changed because of the COVID-19 pandemic. The oncology research community should implement formal policies based on the guidance given from regulatory agencies, with the goal of minimizing the risks of COVID-19 infection while maintaining appropriate oncologic treatments for patients during this pandemic.

Telemedicine Use in Oncology Practices

July 15, 2020

Review Article

ABSTRACT Telemedicine (TM) will play an increasingly significant role in practices that diagnose cancers and treat patients. Although only a small percentage of oncologists currently use TM, many more will embrace this technology in the near future. Although TM has been available for several decades, it was the coronavirus disease 2019 pandemic that highlighted how useful the concept was for connecting and communicating not only with patients who live a significant distance away from their oncologist’s brick-and-mortar office, but with those who are homebound, for whatever reason. For instance, patients who have tested positive for coronavirus but who are not significantly symptomatic can be safely treated while they remain at home. One barrier to the widespread implementation of TM was lack of compensation for the time spent communicating with patients using audio-visual technology. As of March 2020, however, CMS has mandated that TM virtual visits and face-to-face visits have financial parity. This article will explore the process of implementing TM into an oncology practice with minimal time, energy, effort, and expense, as well as the concepts and the trends behind using TM to provide care for patients with cancer.